Antimicrobial Resistance in Pig Farming: Prevalence, Transmission Dynamics, Genetic Determinants, and Policy Implication in Tanzania

Antimicrobial Resistance in Pig Farming: Prevalence, Transmission Dynamics, Genetic Determinants, and Policy Implication in Tanzania | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Antimicrobial Resistance in Pig Farming: Prevalence, Transmission Dynamics, Genetic Determinants, and Policy Implication in Tanzania Valery Sonola, Beatus Lyimo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6440951/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Antimicrobial resistance (AMR) poses a critical global health threat, impacting human, animal, and environmental health. Pigs act as significant reservoirs for multidrug-resistant (MDR) pathogens; however, there is limited data regarding their role in AMR transmission in Tanzania. This study synthesizes existing data on the prevalence, resistance profiles, and genetic determinants of MDR pathogens in pigs, assesses transmission pathways and evaluates Tanzania’s AMR policies in comparison to regional and global strategies. A systematic review of peer-reviewed literature, government reports, and case studies focuses on MDR bacteria, including Escherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp., and methicillin-resistant Staphylococcus aureus (MRSA). E. coli demonstrated a prevalence of up to 73.1% and 51.6% multidrug resistance, while Salmonella spp. and Campylobacter spp. exhibited notable resistance to tetracyclines, beta-lactams, and quinolones. Key resistance genes, such as blaCTX-M, tetM, ermB, mecA, and vanA, were identified, highlighting the potential for horizontal gene transfer and zoonotic transmission. Major AMR transmission routes include direct contact, foodborne exposure, and environmental contamination. Tanzania’s AMR surveillance in pig farming is limited, with weak enforcement of antibiotic regulations and the absence of a coordinated national monitoring system. Comparative policy analysis reveals significant gaps, calling for stricter antibiotic control, improved AMR monitoring, and public education. A One Health approach is crucial, integrating veterinary, public health, and environmental interventions. Strengthening regional collaboration and aligning Tanzania’s AMR policies with global standards is essential to effectively combat the growing AMR threat. Antimicrobial Resistance Multidrug-Resistant Pathogens Pig Farming Resistance Genes Zoonotic Transmission One Health AMR Surveillance Tanzania Antibiotic Stewardship Figures Figure 1 Figure 2 Figure 3 Introduction Antimicrobial resistance (AMR) is a major global health threat, undermining the effectiveness of antibiotics in treating bacterial infections in humans and animals. The World Health Organization (WHO) has classified AMR as one of the top public health threats, warning that without intervention, drug-resistant infections could become the leading cause of mortality worldwide by 2050 [ 1 ]. In both human medicine and livestock farming, excessive and indiscriminate use of antibiotics has contributed to the emergence of multidrug-resistant (MDR) bacteria, complicating disease management, increasing treatment costs, and threatening food safety [ 2 , 3 ]). The livestock sector, particularly pig farming, is a recognized hotspot for AMR development and transmission due to the frequent use of antibiotics for growth promotion, disease prevention, and treatment [ 4 – 6 ]. In Tanzania, pig farming is expanding rapidly, offering economic benefits to smallholder farmers and contributing to national food security. However, this expansion has been accompanied by unregulated antibiotic use, weak veterinary oversight, and a lack of AMR surveillance [ 7 ]. Unlike in some developed countries where strict antibiotic stewardship and surveillance programs exist, Tanzania lacks a comprehensive national AMR monitoring system for livestock. This absence of surveillance increases the risk of resistant bacteria spreading between animals, humans, and the environment through contaminated meat, water sources, and direct contact with farm workers [ 8 , 9 ]. Previous AMR studies in Tanzania have primarily focused on poultry and cattle, leaving significant knowledge gaps regarding AMR in pigs [ 10 , 11 ]. Pigs, however, are highly susceptible to MDR bacteria such as Escherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp. , and Methicillin-resistant Staphylococcus aureus (MRSA) , which have the potential for zoonotic transmission [ 6 ]. Despite emerging global concerns over AMR in pig farming, there is limited data on the prevalence, resistance genes, and virulence factors associated with MDR pathogens in Tanzanian pigs. Additionally, there is no systematic assessment of the AMR policy landscape in Tanzania, making it difficult to evaluate whether existing regulations align with global best practices. This study addresses the identified gaps by providing a comprehensive review of MDR pathogens in pigs in Tanzania and assessing their resistance profiles, genetic determinants, and transmission pathways. The findings will help strengthen AMR surveillance and inform policy recommendations by offering evidence-based insights into the following areas: this study identifies the key MDR bacteria present in pigs in Tanzania, highlighting their resistance levels to commonly used antibiotics. Understanding these resistance patterns is crucial for developing targeted interventions to reduce AMR spread; this study compares the prevalence of resistant E. coli in Tanzanian pigs with findings from other countries, providing a regional and global perspective on AMR trends. This comparison helps determine whether Tanzania’s resistance patterns are unique or reflect broader trends seen in Sub-Saharan Africa and beyond; the study examines the resistance and virulence genes associated with MDR pathogens in pigs, such as blaCTX-M, blaTEM, mecA , and tetM . Identifying these genes provides insights into the molecular mechanisms driving AMR in pig farming and helps predict the risk of horizontal gene transfer, which can accelerate the spread of resistance [ 12 , 13 ]. This study highlights how resistant bacteria spread from pigs to humans and the environment through direct contact, foodborne transmission, and environmental contamination. Understanding these pathways is essential for designing biosecurity measures and public health interventions to minimize zoonotic transmission. Assessment of Tanzania’s AMR Policies Compared to Other Countries: The study evaluates Tanzania’s AMR policy landscape and compares it with policies in South Africa, Kenya, Uganda, the Netherlands, and other nations. Identifying policy gaps and best practices from other countries provides actionable recommendations to strengthen Tanzania’s AMR management framework. By aligning the study objectives with these findings, this research provides critical insights into AMR in Tanzanian pig farming, emphasizing the urgent need for improved surveillance, stricter antibiotic regulations, and enhanced public awareness. Additionally, the findings contribute to the broader One Health framework, which recognizes the interconnectedness of human, animal, and environmental health in AMR mitigation strategies. This study aims to bridge the knowledge gaps on AMR in Tanzanian pigs by addressing the following specific objectives: (1) to determine the prevalence and antimicrobial resistance profiles of MDR pathogens in pigs in Tanzania ( Escherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp., and MRSA ) (2) to compare the prevalence and MDR rates of E. coli isolated from pigs in Tanzania with other countries in Sub-Saharan Africa and globally (3) to identify resistance and virulence genes associated with MDR pathogens isolated from pigs in Tanzania (4) to examine the major transmission pathways of AMR from pigs to humans and the environment and to evaluate the current AMR policy landscape in Tanzania and compare it with policies in other countries to identify gaps and recommend improvements. The findings of this study are critical for policymakers, veterinarians, farmers, and public health professionals in Tanzania and beyond. By identifying key resistance patterns, genetic determinants, and transmission risks, this research will: support the development of evidence-based AMR surveillance programs tailored to pig farming; guide policymakers in designing effective antibiotic stewardship policies to control AMR in livestock; raise awareness among farmers and veterinarians about responsible antibiotic use and biosecurity measures; provide a comparative framework for understanding Tanzania’s AMR burden in relation to other countries; and contribute to regional and global efforts to combat AMR through data-driven interventions and One Health collaborations. In summary, AMR in pig farming is an emerging public health and food safety threat in Tanzania, with implications for human health and environmental sustainability. This study fills critical knowledge gaps by analyzing the prevalence, resistance mechanisms, and transmission dynamics of MDR pathogens in pigs while also assessing the effectiveness of Tanzania’s AMR policies. Strengthening AMR surveillance, enforcing stricter antibiotic regulations, and adopting a coordinated One Health approach are essential steps toward mitigating the risks posed by AMR in Tanzania’s pig farming sector. Methodology This review paper aims to provide a comprehensive analysis of the current state of antimicrobial resistance (AMR) in pigs, focusing on multidrug-resistant (MDR) pathogens, their resistance and virulence genes, and their role in the transmission of AMR between pigs, humans, and the environment. The methodology adopted in this study involves systematically reviewing, synthesizing, and comparing research from various sources to address the research problem and gaps in knowledge. 2.1 Literature Search and Inclusion Criteria A systematic literature search will be conducted using electronic databases such as PubMed, ScienceDirect, Scopus, and Google Scholar. The search will cover articles published from 2000 to 2024 to capture both historical and contemporary perspectives on AMR in pigs. The following keywords and combinations will be used: "multidrug-resistant pathogens in pigs," "antimicrobial resistance in pig farming," "AMR resistance genes in pigs," "AMR transmission from pigs to humans," "virulence factors in pigs," and "AMR policy in Tanzania." Table 1 Criteria for selecting studies relevant to the review and excluding those lacking essential parameters for addressing the research problem Criteria Inclusion Exclusion Study Type Peer-reviewed articles, government reports, and case studies Non-peer-reviewed publications (e.g., opinion pieces, editorials) Publication Year Studies published from 2000 onwards Studies published before 2000 Language English Non-English studies (unless translated) Geographical Scope Studies focusing on Tanzania, Sub-Saharan Africa, and global context Studies focusing on regions outside Sub-Saharan Africa (unless directly comparable) Pathogens Studies on Escherichia coli , Salmonella spp. , Campylobacter spp. , Enterococcus spp. , Methicillin-resistant Staphylococcus aureus (MRSA), and other MDR pathogens in pigs Studies that do not focus on MDR pathogens or are not related to pig populations Study Focus Research on antimicrobial resistance (AMR), resistance and virulence genes, zoonotic transmission, and AMR policy in pigs Studies that focus on other aspects of pig health unrelated to AMR or do not investigate AMR in pigs Data Type Studies reporting prevalence rates, resistance patterns, gene detection, and policy analysis Studies with insufficient or unclear data on AMR prevalence or resistance patterns in pigs Methodology Studies employing microbiological, molecular, or epidemiological methods for AMR detection Studies with unverified methods or lack of transparency in the methodology Region Specificity Research conducted in Tanzania or comparable Sub-Saharan African countries (in terms of AMR relevance) Studies from countries outside the targeted regions (unless they provide context for Tanzania) Antimicrobial Resistance Focus Studies that assess AMR in livestock with a focus on pigs and its zoonotic impact Studies on AMR in humans or other animal species not relevant to pigs or livestock 2.2 Data Extraction and Synthesis Once eligible studies were identified, relevant data were extracted and organized into themes to address the research objectives. Key aspects of each study examined, included: Pathogens Isolated: the types of MDR pathogens commonly isolated from pigs, such as Escherichia coli , Salmonella spp. , Campylobacter spp. , and Enterococcus spp.; Resistance Profiles: the antibiotics tested, and the resistance profiles of pathogens in relation to commonly used veterinary and human antibiotics (e.g., tetracyclines, beta-lactams, quinolones); Resistance Genes: The identification of resistance genes such as blaCTX-M , tetM , ermB , aac(3)-IV , and others in MDR pathogens; Virulence Factors: Identification of virulence genes that contribute to the pathogenicity of the pathogens, such as stx1 , stx2 , InvA , and cadF ; Transmission Pathways: Insights into how AMR pathogens are transmitted from pigs to humans and the environment, and the factors that contribute to the spread of resistance; and AMR Policy and Management: An analysis of AMR policies in Tanzania and other Sub-Saharan African countries, including the extent of their implementation and effectiveness. The data were organized in tabular form for clarity, and qualitative synthesis was performed to highlight trends, challenges, and gaps in the current literature. 2.3 Analysis of AMR Policy Implementation In addition to reviewing microbiological studies, this review analyzed the policy framework surrounding AMR in pig farming in Tanzania, comparing it with similar policies in Sub-Saharan African countries and high-income nations. The following steps were taken: Policy Review : Relevant government policies, regulations, and guidelines on AMR in Tanzania were reviewed from sources such as the Ministry of Health, the Ministry of Livestock, and international organizations (e.g., WHO, FAO, OIE). A comparison was made between Tanzania’s policy landscape and that of other Sub-Saharan African countries with a more developed regulatory framework for AMR. Effectiveness Assessment : The study assessed the reported effectiveness of AMR policies in reducing resistance levels, focusing on whether they address key drivers such as inappropriate antibiotic use in livestock farming, insufficient surveillance, and poor farm biosecurity practices. Barriers to Policy Implementation : The review highlighted challenges to AMR policy enforcement in Tanzania, including insufficient resources, lack of awareness among farmers, and weak regulatory structures. Case studies from other SSA countries were used to draw lessons for improving Tanzania's AMR policy and implementation [ 14 ]. 2.4 Comparative Analysis with Other Countries This review included a comparative analysis of AMR in pigs and AMR policy implementation between Tanzania and other countries, both in Sub-Saharan Africa and globally. Countries with active AMR surveillance systems and strong regulatory frameworks, such as South Africa, Kenya, and the Netherlands, were used as benchmarks. Key factors that were compared included: AMR Prevalence: The rate of AMR in pigs in comparison to other livestock species, particularly in countries with advanced surveillance systems; Antimicrobial Usage: The role of antimicrobial use in livestock, particularly in pig farming, and its correlation with AMR prevalence; Policy Responses: The types of policies implemented to curb AMR, including antibiotic stewardship programs, surveillance systems, and regulations on veterinary drug use. This cross-country comparison will allow for a better understanding of how different policy approaches impact AMR trends and offer recommendations for Tanzania. 2.5 Limitations of the Study Given the nature of this review, it is important to acknowledge several limitations: Incomplete Data: Some regions may lack published data on AMR in pigs, particularly in low-resource settings like Tanzania; Language Bias: Most studies published in English may overlook local publications in other languages, potentially limiting the comprehensiveness of the review; and Variability in Methodology: Differences in sampling, testing methods, and reporting standards across studies may affect the comparability of results. Despite these limitations, the comprehensive nature of the review will provide valuable insights into the state of AMR in pigs and help inform policy recommendations for Tanzania and other Sub-Saharan African countries. Results 3.1 The resistance patterns of MDR pathogens isolated from pigs in Tanzania Table 1 lists the common MDR bacterial pathogens found in pigs in Tanzania, their sample sources, resistance profiles, and detected resistance genes. Escherichia coli was the most commonly isolated MDR pathogen, sourced from pig feces and carcasses. It exhibited resistance to tetracycline, ampicillin, and sulfonamides, with blaCTX-M, tetM, aac(3)-IV , and ermB genes detected. Salmonella spp. , isolated from pig intestines and feces, showed resistance to ampicillin and ciprofloxacin, carrying blaTEM and tetA genes. Campylobacter spp. , found in pig intestines and carcasses, displayed resistance to erythromycin and tetracycline, with the presence of ermB and tetO genes. Enterococcus spp. exhibited vancomycin and tetracycline resistance, linked to vanA and tetM genes. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in pig skin, nasal cavities, and feces, resistant to methicillin, oxacillin, and tetracycline, with the mecA and tetM genes contributing to its antimicrobial resistance. Table 1 MDR Pathogens in Pigs in Tanzania MDR Pathogen Commonly Isolated From Resistance Profile Resistance Genes Identified References Escherichia coli Pig feces, carcasses Resistant to tetracycline, ampicillin, sulfonamides blaCTX-M , tetM , aac(3)-IV , ermB [ 7 , 14 , 15 ] Salmonella spp. Pig intestines, feces Resistance to ampicillin, ciprofloxacin, tetracycline blaTEM , tetA , strA [ 16 , 17 ] Campylobacter spp. Pig intestines, carcasses Resistance to erythromycin, tetracycline ermB , tetO [ 18 , 19 ] Enterococcus spp. Pig feces, intestines Resistant to vancomycin, tetracycline vanA , tetM [ 20 ] MRSA Pig skin, nasal cavities, feces Resistant to methicillin, oxacillin, tetracycline, and some beta-lactams mecA , tetM [ 21 , 22 ] 3.2 Isolation Frequencies of Resistant Pathogens from Pig Samples in Different Areas of Tanzania This table summarizes the isolation frequencies of various MDR pathogens from pig samples in different regions of Tanzania, along with detected resistance genes and virulence factors. The highest E. coli prevalence was found in Dar es Salaam (73.1%) and Arusha (71.1%), with resistance genes blaCTX-M, mecA, tetM , and ermB frequently detected. Salmonella spp. had 66.7% prevalence in carcass samples in Arusha and 5.2% in fecal samples from other regions. Campylobacter jejuni showed isolation rates between 26.7% (Morogoro) and 34.8% (cecum samples). Staphylococcus aureus was identified in 4% of nasal swabs in Morogoro, carrying the mecC gene. Table 2 Isolation Frequencies of Resistant Pathogens from Pig Samples in Different areas of Tanzania Study Area Sample Type Sample Size Bacteria Isolated Isolation Frequency (%) Resistance Genes and Virulence Factors Detected References Dar es Salaam Fecal 150 E. coli 73.1% blaCTX-M , tetM , aac(6)-Ib-cr , qnrB , stx1 , stx2 (Shiga toxins) [ 7 , 23 ] Arusha Carcass 120 E. coli Salmonella spp. 71.1% 66.7% mecA , tetM , ermB , vanA , cadF , agg [ 24 ] Fecal 864 Campylobacter jejuni 32.5 Not studied [ 19 ] Morogoro Pig feces 466 Campylobacter jejuni 26.7% Not studied [ 25 ] Nasal swabs 100 Staphylococcus aureus 4% mecC [ 21 ] Cecum 66 Campylobacter jejuni 34.8% Not studied [ 26 ] Small intestine 66 Campylobacter jejuni 28.8% Not studied Colon 66 Campylobacter coli 16.7% Not studied Mwanza Fecal 297 E. coli 31.8% [ 23 ] Fecal 134 E. coli 93.3% BlaCTX-M-15, strA, strB , aac(6)-Ib-cr, qnrS1 [ 27 ] 3.3 Isolation of Resistant E. coli in Pigs in Tanzania, SSA, and Global Countries This table compares the prevalence and multidrug resistance (MDR) rates of E. coli in pigs from Tanzania, Sub-Saharan Africa (SSA), and global regions. E. coli prevalence in Tanzania was 73.1%, with an MDR rate of 51.6%, similar to Uganda (81.4% prevalence, 56% MDR). South Africa had the highest E. coli prevalence (94%) and MDR rate (67%), while Kenya reported 47.7% prevalence with 38.5% MDR. Industrialized countries like Germany (50.5%) and Spain (26%) had lower prevalence rates, likely due to stricter antibiotic regulations. China had an MDR rate of 96.3%, highlighting high antibiotic use in pig farming. Table 3 Isolation of Resistant E. coli in Pigs in Tanzania, SSA, and Global Countries Country Sample Type Sample Size Isolation Frequency % MDR% Source of Variation of Data References Tanzania Pig feces, carcasses 308 73.1% 51.6% Overuse of antibiotics, weak surveillance systems, and self-medication among farmers. [ 7 ] Kenya Carcass 393 47.7% 38.5% Differences in farming systems, feed types, and access to veterinary care. Overuse of antibiotics [ 1 , 28 ] Uganda Fecal 215 81.4% 56% Inconsistent data due to a lack of proper monitoring and regional differences in farming practices. [ 29 ] South Africa Rectal swabs 322 94% 67% Differences in Farming practices & overuse of antibiotics [ 30 ] Brazil Fecal, 306 33.7% 37% High levels of antibiotic use in industrial pig farming contribute to higher resistance rates. [ 31 ] Spain Fecal 94 26% 97.5% Regulations on antimicrobial use and farming practices in place lead to a moderate prevalence. [ 32 ] Germany Slaughter wastes 376 50.5% 49.2% Co-selection through other antimicrobials that are used in pigs (macrolides, lincosamides & tetracyclines) [ 33 ] China Carcass 155 32.9% 96.3% Controlled use of antibiotics in pig farming and regulated veterinary practices. [ 34 ] India Fecal 124 44.4% 100% Low enforcement of regulations, varied farming systems, and limited surveillance networks. [ 35 , 36 ] 3.4 Comparative Isolation Frequencies of Resistant E. coli Strains Globally Figure 1 presents a comparative analysis of E. coli isolation rates in pigs from different countries, illustrating variation in resistance levels based on antibiotic use practices and regulations. Tanzania’s E. coli prevalence (73.1%) was higher than Brazil (33.7%) and Spain (26%), but lower than South Africa (94%). Countries with stricter antibiotic regulations (e.g., Spain and Germany) showed lower prevalence, emphasizing the role of regulatory policies in AMR control. 3.5 Reported Prevalence Rates of Multidrug-Resistant E. coli Globally Figure 2 illustrates the global prevalence of MDR E. coli strains in pig farming, comparing Tanzania’s rates with those from other regions. MDR rates were highest in India (100%) and China (96.3%), while Tanzania had a moderate MDR rate (51.6%). European countries, such as Spain (97.5%) and Germany (49.2%), showed controlled resistance levels due to regulated antibiotic usage. 3.6 Resistance and Virulence Genes in MDR Pathogens Table 4 summarizes the resistance and virulence genes identified in MDR pathogens isolated from pigs in Tanzania. E. coli carried resistance genes blaCTX-M, tetM, ermB , along with virulence genes stx1, stx2 (Shiga toxins). Salmonella spp. harbored blaTEM and tetA , with virulence genes invA and fimH , known for enhancing bacterial adhesion. MRSA contained the mecA gene for methicillin resistance and virulence factors clfA, cna , and spa , increasing its pathogenic potential. Table 4 Resistance and Virulence Genes in MDR Pathogens Pathogen Resistance Genes Virulence Genes References Escherichia coli blaCTX-M , tetM , aac(3)-IV , ermB stx1 , stx2 (Shiga toxins), InvA , cadF [ 37 , 38 ] Salmonella spp. blaTEM , tetA , strA invA , spvC , fimH [ 39 , 40 ] Campylobacter spp. ermB , tetO cadF , cheW , Cj1349 [ 18 , 41 ] Enterococcus spp. vanA , tetM esp , agg [ 42 , 43 ] Methicillin-resistant Staphylococcus aureus (MRSA) mecA , tetM clfA , cna , spa [ 21 , 44 ] 3.7 Role of Pigs in Transmission of AMR to Humans and Environment Table 5 highlights the major transmission routes of AMR pathogens from pigs to humans and the environment, along with estimated risk levels. Direct contact with pigs poses the highest AMR transmission risk (40%) for farm workers. Consumption of undercooked pork is responsible for 30% of AMR spread. Environmental contamination through manure and wastewater accounts for 25% of AMR transmission. Table 5 Role of Pigs in Transmission of AMR to Humans and Environment Transmission Route Key Findings Estimated Risk/Impact of AMR Spread References Direct Contact Farmers and farm workers are at higher risk of carrying MDR pathogens due to direct contact with pigs. 40% risk of AMR transmission to humans [ 3 , 45 ] Consumption of Undercooked Pork Undercooked pork is a source of AMR pathogens, especially E. coli and Salmonella . 30% risk of AMR spread through food [ 46 , 47 ] Environmental Contamination AMR pathogens are transmitted to the environment through pig manure and wastewater, contributing to soil and water contamination. 25% impact on soil and water systems [ 8 , 18 ] Farm Workers as Carriers AMR pathogens are carried by farm workers to homes, local communities, and markets. 20% impact on community AMR spread [ 18 , 48 ] 3.8 The Transmission Routes of AMR Pathogens from Pigs to Humans and the Environment Figure 3 illustrates the pathways through which AMR pathogens spread from pigs to humans and the environment. Direct pig-human contact is the primary route of transmission. Foodborne transmission occurs through contaminated pork products. Environmental pathways include AMR dissemination through soil and water contamination. 3.9A AMR Policies in Tanzania and Comparison with Other Countries Table 6 compares the AMR policy status in Tanzania with several other countries, including South Africa, Kenya, Uganda, the Netherlands, and the USA. Tanzania is shown to have a limited formal AMR policy framework, with inadequate enforcement of antibiotic use regulations in agriculture. In contrast, countries like South Africa and the Netherlands have established comprehensive AMR policies with strong regulatory frameworks and surveillance systems. The table highlights the gaps in Tanzania's AMR strategy, particularly in areas such as antibiotic use regulation and surveillance, which are more robust in the comparison countries. The findings suggest that Tanzania could benefit from a more coordinated and well-enforced AMR policy to reduce the spread of resistant pathogens in livestock. Table 6 AMR Policies in Tanzania and Comparison with Other Countries Country/Region AMR Policy Status Key Findings References Tanzania Limited formal AMR policy framework. Insufficient regulatory enforcement on antibiotic use in agriculture. Lack of comprehensive AMR surveillance programs. Need for stronger regulation of veterinary antibiotics. [ 1 , 41 ] South Africa Established AMR policy framework with national surveillance systems. Stronger regulatory enforcement. Effective AMR surveillance in livestock. [ 18 , 49 ] Kenya AMR policy was implemented with a focus on human health but limited enforcement in agriculture. Growing recognition of the role of animal agriculture in AMR transmission. [ 1 , 41 ] Uganda Limited but developing AMR strategy with nascent surveillance programs. Increased focus on zoonotic transmission, but gaps in AMR data collection and analysis. [ 41 , 49 ] Netherlands (Global) Comprehensive AMR policies and regulations, including restrictions on antibiotic use in livestock. Advanced surveillance systems and enforcement of antibiotic stewardship programs in livestock farming. [ 18 , 49 ] 3.9B Recommendations for Improving AMR Policy in Tanzania Table 7 outlines key recommendations to improve AMR policy in Tanzania, based on the findings from the review. The recommendations include strengthening the regulatory framework for antibiotic use in livestock, developing national AMR surveillance systems, implementing awareness programs for farmers and farm workers, and fostering international collaborations to improve resource availability and technical support. The expected outcomes of these interventions include reduced antibiotic misuse in farming, improved AMR data collection, and more effective control measures to curb the spread of resistance. The recommendations also highlight the importance of integrating AMR control into broader public health and agricultural strategies. Table 7 Recommendations for Improving AMR Policy in Tanzania Recommendation Key Actions Expected Outcomes References Strengthening Regulatory Framework Tightening regulations on antimicrobial use in livestock. Introduction of stricter licensing for veterinary drugs. Reduced use of unnecessary antibiotics in pig farming. [ 18 , 49 ] Developing National AMR Surveillance Systems Establishment of a nationwide AMR surveillance network, including farms, slaughterhouses, and markets. Improved data on AMR prevalence and spread. Better informed policies. [ 1 , 41 ] Farmer and Worker Awareness Programs Educational programs focusing on responsible antibiotic use, biosecurity, and hygiene practices. Reduction in AMR transmission within farms and communities. [ 18 , 49 ] Strengthening International Collaborations Collaboration with international organizations (e.g., WHO, FAO) to implement best practices in AMR control. Increased resource availability and technical support. [ 1 , 49 ] Discussion The study revealed high prevalence rates of MDR E. coli (73.1%) and other MDR pathogens such as Salmonella spp. , Campylobacter spp. , Enterococcus spp. , and MRSA in Tanzanian pigs (Tables 1 and 2 ). The detection of genes such as blaCTX-M , tetM , ermB , mecA , and vanA indicates the presence of extensive resistance mechanisms in these bacteria. These findings align with studies from other Sub-Saharan African (SSA) countries, including Uganda and Kenya, where similar resistance genes were detected in livestock [ 29 , 46 ]. However, compared to European countries such as Germany and the Netherlands, where strict antibiotic stewardship is enforced, Tanzania's resistance prevalence is significantly higher [ 33 ]. This suggests that weak surveillance and unregulated antibiotic use in Tanzanian pig farming contribute to escalating AMR. The implications of these findings are severe, as MDR bacteria can be transmitted from pigs to humans through direct contact or foodborne pathways, increasing the risk of untreatable infections. The resistance patterns observed in Tanzanian pigs underscore the urgent need for strengthened AMR surveillance and stricter regulations on antibiotic use in livestock farming. The comparison of E. coli resistance levels globally (Table 3 , Figs. 1 and 2 ), shows that Tanzania's prevalence (73.1%) is among the highest, comparable to South Africa (94%) but lower than Uganda (81.4%). Meanwhile, industrialized countries like Germany (50.5%) and Spain (26%) have significantly lower rates due to stringent antibiotic use regulations [ 32 ]. Interestingly, China and India report alarmingly high MDR rates of E. coli (> 96%), which can be attributed to excessive antibiotic use in intensive pig farming [ 34 , 35 ]. The similarity between Tanzania and other SSA nations suggests common drivers of AMR, including unregulated antibiotic access, lack of veterinary oversight, and poor farm hygiene [ 50 ]. The high MDR E. coli prevalence in Tanzania means that resistant bacterial strains could enter the human food chain, increasing the burden of AMR-related diseases. Learning from countries like the Netherlands, which have significantly reduced AMR through national stewardship programs [ 51 ], Tanzania must develop policies to regulate antibiotic use in livestock farming. The study identified key resistance genes ( blaCTX-M, blaTEM, mecA, tetM, vanA ) and virulence genes ( stx1, stx2, invA, fimH ) in MDR pathogens (Table 4 ). The presence of stx1 and stx2 in E. coli suggests a high risk of severe diarrheal diseases in humans, while mecA -positive MRSA strains indicate a zoonotic threat [ 52 ]. Compared to global data, Tanzanian pigs harbor resistance genes similar to those found in China, Brazil, and India, reinforcing concerns over the horizontal gene transfer of resistance elements [ 31 , 53 , 54 ]. The risk of zoonotic transmission and environmental contamination increases when these resistant pathogens persist in livestock populations. Immediate intervention strategies, including better veterinary oversight and biosecurity measures, are necessary to mitigate these risks in Tanzania. Direct pig-human contact was identified as the highest-risk transmission route (40%), followed by consumption of undercooked pork (30%) and environmental contamination (25%) (Table 5 and Fig. 3 ). These findings align with studies from South Africa, where farm workers frequently act as carriers of resistant bacteria [ 9 ]. Furthermore, poor waste management in Tanzanian pig farms exacerbates environmental contamination, allowing AMR pathogens to persist in water and soil [ 55 ]. Given these transmission pathways, biosecurity measures such as improved hygiene practices, controlled antibiotic use, and proper manure disposal are critical in Tanzania. Lessons from the European Union [ 56 ], where strict sanitation protocols and controlled antibiotic use have reduced AMR transmission, could guide interventions in Tanzania. Tanzania's AMR policy framework is weak compared to South Africa and the Netherlands, which have well-established national AMR surveillance programs and strict antibiotic regulations [ 49 ]. Kenya and Uganda have made strides in AMR control but still lack stringent enforcement mechanisms [ 1 ]. The absence of a national AMR monitoring system in Tanzania allows for unchecked antibiotic use, exacerbating resistance rates. Implementing a structured AMR policy, similar to the Netherlands’ national antibiotic reduction program, could significantly curb resistance development in livestock [ 57 ]. Tanzania must strengthen its regulatory framework and enforce stricter antibiotic stewardship measures to align with global best practices. The key recommendations (Table 6 ) include: implementing stricter laws on veterinary antibiotic use and improving drug licensing regulations [ 49 ]; monitoring AMR trends across farms, slaughterhouses, and markets to track resistance patterns [ 41 ]; educating stakeholders on responsible antibiotic use, biosecurity, and hygiene measures [ 18 ]; investing in research and international collaborations such as partnering with WHO, FAO, and regional organizations to develop AMR control strategies [ 6 ]. The study highlights a critical AMR burden in Tanzanian pig farming, emphasizing the need for urgent policy interventions. High MDR pathogen prevalence, resistance gene detection, and weak regulatory enforcement pose severe threats to public health. Drawing lessons from global best practices, Tanzania must strengthen antibiotic regulations, enhance surveillance, and promote responsible antimicrobial use to mitigate the AMR crisis in livestock farming. Conclusion The study highlights a critical AMR burden in Tanzanian pig farming, emphasizing the need for urgent policy interventions. High MDR pathogen prevalence, resistance gene detection, and weak regulatory enforcement pose severe threats to public health. Drawing lessons from global best practices, Tanzania must strengthen antibiotic regulations, enhance surveillance, and promote responsible antimicrobial use to mitigate the AMR crisis in livestock farming. Recommendations ​To effectively combat antimicrobial resistance (AMR) in Tanzania's livestock sector, the following key policy recommendations are proposed:​ 1. Strengthen Regulatory Frameworks Enforce Prudent Use: Regulate antimicrobial use, limiting it to therapeutic purposes under veterinary oversight. Restrict OTC Sales: Ban the sale of critical antimicrobials without prescription to curb misuse. 2. Enhance Surveillance and Monitoring Build Surveillance Systems: Develop integrated systems to track antimicrobial use and resistance across sectors. Promote Research & Data Sharing: Support research and dissemination to guide policy and action. 3. Promote Education and Awareness Train Stakeholders: Provide ongoing training for farmers, vets, and health workers on responsible use and AMR risks. Raise Public Awareness: Run national campaigns highlighting AMR and proper treatment adherence. 4. Improve Biosecurity and Farming Practices Promote Good Husbandry: Encourage disease-preventive practices to reduce antimicrobial needs. Strengthen Biosecurity: Enforce strict farm biosecurity to block infection spread. 5. Invest in Vaccination Programs Develop and Distribute Vaccines: Boost vaccine use to prevent infections and reduce antimicrobial reliance. 6. Foster One Health Collaboration Promote Cross-Sector Coordination: Unite human, animal, and environmental sectors against AMR. Partner Internationally: Work with global bodies and neighbors to share AMR solutions and resources. Implementing these recommendations requires a coordinated effort from government agencies, the private sector, and civil society to effectively mitigate the threat of AMR in Tanzania's livestock industry. Declarations Acknowledgment Not applicable Funding: This work was not funded. There was no any funding received for this work. Author contributions Conceptualization: All authors; Writing the original draft: V.S.S.; Writing-review & Editing: B.L. Ethics approval: This study is a literature-based review, so ethical clearance was not required. However, ethical integrity was ensured by properly citing all sources, avoiding plagiarism, and acknowledging the original authors of all data used. Consent to Participate declaration : not applicable Consent for publication None Competing Interests The authors declare no competing interests Author Details 1 Livestock Training Agency (LITA), Buhuri Campus, P.O. Box 1483, Tanga, Tanzania. [email protected] 2 Nelson Mandela African Institution of Science and Technology (NIM-AIST), P. O. Box 447, Arusha, Tanzania. [email protected] References WHO., Antimicrobial resistance: A global health crisis.. World Health Organization., 2019. Fatima, Z., et al., Multidrug resistance: a threat to antibiotic era , in Biological and Environmental Hazards, Risks, and Disasters . 2023, Elsevier. p. 197–220. Matheou, A., et al., Antibiotic Use in Livestock Farming: A Driver of Multidrug Resistance? Microorganisms, 2025. 13(4): p. 779. Khairullah, A.R., et al., Potential of the livestock industry environment as a reservoir for spreading antimicrobial resistance . Open Veterinary Journal, 2025. 15(2): p. 504. 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Frontiers in Microbiology, 2015. 6: p. 1240. Katakweba, A.A., et al., First report on a randomized investigation of antimicrobial resistance in fecal indicator bacteria from livestock, poultry, and humans in Tanzania . Microbial drug resistance, 2018. 24(3): p. 260–268. Katakweba, A.S., et al., spa typing and antimicrobial resistance of Staphylococcus aureus from healthy humans, pigs and dogs in Tanzania . The Journal of Infection in Developing Countries, 2016. 10(02): p. 143–148. Mzee, T., et al., Prevalence, antimicrobial susceptibility and genotypic characteristics of Staphylococcus aureus in Tanzania: a systematic review . Bulletin of the National Research Centre, 2021. 45(1): p. 162. Mtemisika, C.I., et al., Epidemiological cut-off values and multidrug resistance of escherichia coli isolated from domesticated poultry and pigs reared in mwanza, Tanzania: a cross-section study . Animals, 2022. 12(7): p. 835. Luanda, C., et al., Bacterial contamination of pork carcasses from Arusha, Tanzania. 2016. Komba, E.V., et al., Occurrence, species distribution and antimicrobial resistance of thermophilic Campylobacter isolates from farm and laboratory animals in Morogoro , Tanzania. Veterinary world, 2014. 7(8). Mdegela, R.H., et al., Occurrences of thermophilic Campylobacter in pigs slaughtered at Morogoro slaughter slabs, Tanzania . Tropical animal health and production, 2011. 43: p. 83–87. Seni, J., et al., Multiple ESBL-producing Escherichia coli sequence types carrying quinolone and aminoglycoside resistance genes circulating in companion and domestic farm animals in Mwanza, Tanzania, harbor commonly occurring plasmids . Frontiers in microbiology, 2016. 7: p. 142. Muinde, P.M., J.; Momanyi, K.; Yamo, V.; Mwaniki, J.; Kiiru, J., Antimicrobial Resistant Pathogens Detected in Raw Pork and Poultry Meat in Retailing Outlets in Kenya.. Antibiotics 2023. 12: p. 613. Tusiime, M., et al., Molecular characterization of Escherichia coli virulence markers in neonatal and postweaning piglets from major pig-producing districts of Uganda . BMC Veterinary Research, 2024. 20(1): p. 230. Sikhosana, Z.E.L., Prevalence and Antibiotic Sensitivity of Enterotoxigenic Escherichia Coli Isolates in South African Pig Population . 2015, University of KwaZulu-Natal, Pietermaritzburg. Brisola, M.C., et al., Escherichia coli used as a biomarker of antimicrobial resistance in pig farms of Southern Brazil . Science of the total environment, 2019. 647: p. 362–368. Vidal, A., et al., Antimicrobial resistance profiles and characterization of Escherichia coli strains from cases of neonatal diarrhea in Spanish pig farms . Veterinary sciences, 2020. 7(2): p. 48. Savin, M., et al., Clinically relevant Escherichia coli isolates from process waters and wastewater of poultry and pig slaughterhouses in Germany . Microorganisms, 2021. 9(4): p. 698. Lu, X., et al., Prevalence and genomic characteristics of mcr-positive Escherichia coli strains isolated from humans, pigs, and foods in China . Microbiology Spectrum, 2023. 11(3): p. e04569-22. Tamta, S., et al., Antimicrobial resistance pattern of extended-spectrum β-lactamase-producing Escherichia coli isolated from fecal samples of piglets and pig farm workers of selected organized farms of India . Veterinary World, 2020. 13(2): p. 360. Tumlam, U.M., et al., Phylogenetic analysis and antimicrobial resistance of Escherichia coli isolated from diarrheic piglets. 2022. Kehrenberg, C., et al., Antimicrobial resistance in members of the family Pasteurellaceae . Antimicrobial resistance in bacteria of animal origin, 2005: p. 167–186. Olsen, R.H., et al., Experimental induced avian E. coli salpingitis: Significant impact of strain and host factors on the clinical and pathological outcome . Veterinary Microbiology, 2016. 188: p. 59–66. Carter, M.Q., et al., An environmental Shiga toxin-producing Escherichia coli O145 clonal population exhibits high-level phenotypic variation that includes virulence traits . Applied and Environmental Microbiology, 2016. 82(4): p. 1090–1101. Abdalla, S.E., et al., From farm-to-fork: E. coli from an intensive pig production system in South Africa shows high resistance to critically important antibiotics for human and animal use . Antibiotics, 2021. 10(2): p. 178. Moyo, N.B., Quantitative analysis of selected antibiotic drug residues in honey and manure samples using modern analytical techniques . 2021. Beshiru, A., et al., Multi-antibiotic resistant and putative virulence gene signatures in Enterococcus species isolated from pig farms environment . Microbial pathogenesis, 2017. 104: p. 90–96. Iweriebor, B.C., L.C. Obi, and A.I. Okoh, Virulence and antimicrobial resistance factors of Enterococcus spp. isolated from fecal samples from piggery farms in Eastern Cape, South Africa . BMC microbiology, 2015. 15: p. 1–11. Sineke, N., et al., Staphylococcus aureus in intensive pig production in South Africa: Antibiotic resistance, virulence determinants, and clonality . Pathogens, 2021. 10(3): p. 317. George, A.N., et al., Risk of Antibiotic-Resistant Staphylococcus aureus Dispersion from Hog Farms: A Critical Review . Risk Analysis, 2020. 40(8): p. 1645–1665. Muinde, P., et al., Antimicrobial resistant pathogens detected in raw pork and poultry meat in retailing outlets in Kenya . Antibiotics, 2023. 12(3): p. 613. Nastasijevic, I., et al., Tracking antimicrobial resistance along the meat chain: One health context . Food Reviews International, 2024. 40(9): p. 2775–2809. Samtiya, M., et al., Antimicrobial resistance in the food chain: trends, mechanisms, pathways, and possible regulation strategies . Foods, 2022. 11(19): p. 2966. FAO, Food and Agriculture Organization. The FAO Action Plan on Antimicrobial Resistance 2016–2020. . Rome: FAO., 2016. Michael, C.A., & Kadi, M., Antimicrobial resistance in the pig sector of Tanzania: A review of farm-level practices and regulatory framework. . Tanzania Journal of Agriculture., 2021. 43(2): p. 19–28. Prinsen, H., et al., A coaching approach to strengthen farm management teams to reduce antimicrobial use in Dutch high usage pig farms: a 2 year intervention study . Frontiers in Veterinary Science, 2024. 11: p. 1422756. Zong, Z., & Zhang, X., The role of Enterococcus spp. in the transmission of AMR: A review with focus on pigs. . Journal of Antimicrobial Chemotherapy,, 2021. 76(2): p. 304–313. Hu, Z., et al., Genomic epidemiology of antimicrobial resistance determinants in Chinese swine farm Escherichia coli isolates . Frontiers in Microbiology, 2025. 16: p. 1575426. Ku, U. and R. Karwasra, Descriptive genomic analysis of antibiotic resistance in Pasteurella multocida isolates from India . Journal of Zoonotic Diseases, 2025. 9(2): p. 771–780. Sharma, P., et al., Antibiotic and Non-Antibiotic Determinants of Antimicrobial Resistance: Insights from Water Ecosystems . ACS ES&T Water, 2024. 4(11): p. 4671–4689. Gaze, W.H., & Knapp, C. W., The significance of antimicrobial resistance in environmental reservoirs: Review and analysis of global patterns. . Science of the Total Environment,, 2015. 536: p. 29–42.. Panel, E.B., et al., Occurrence and spread of carbapenemase-producing Enterobacterales (CPE) in the food chain in the EU/EFTA. Part 1: 2025 update . EFSA Journal, 2025. 23(4): p. e9336. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6440951","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":451483725,"identity":"0f53a6af-ce13-4818-97a6-abed0d763b9b","order_by":0,"name":"Valery Sonola","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYPACCwZ+EJVQQLwWCQbJBpAWA1K0GBwA0cRoMTh//OHjggoJeePzqxM/PDBgkOcXO0BAy40cY+MZZyQMt914u1kC6DDDmbMT8GuRnMHDJs3bJsG47cbZDSAtCQa3CWnpP/4MpMV+84yzm38QpYWfIcEMpCVxA3/vNuJs4ZcA+oXnjETyjBu82ywSDCQI+4WNHxhiPBU2tv39Zzff/FFhI88vTUALAkiAVUoQqxzsxAOkqB4Fo2AUjIKRBAA4YD8b4ciMugAAAABJRU5ErkJggg==","orcid":"","institution":"Livestock Training Agency (LITA), Buhuri Campus, Tanga, Tanzania.","correspondingAuthor":true,"prefix":"","firstName":"Valery","middleName":"","lastName":"Sonola","suffix":""},{"id":451483726,"identity":"35dc6d40-b37b-47eb-bca2-7f9a051d3205","order_by":1,"name":"Beatus Lyimo","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Beatus","middleName":"","lastName":"Lyimo","suffix":""}],"badges":[],"createdAt":"2025-04-13 20:08:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6440951/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6440951/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82070426,"identity":"93caea9a-76ec-40e0-a130-fe98553e916a","added_by":"auto","created_at":"2025-05-06 13:11:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43302,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparative isolation frequencies of resistant-\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eE. coli\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e strains globally\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6440951/v1/489883726b4c42646e58c994.png"},{"id":82070425,"identity":"9393e070-2606-4463-b522-038b50de9283","added_by":"auto","created_at":"2025-05-06 13:11:19","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":52195,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eReported prevalence rates of multidrug-resistant \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003eE. coli\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e globally\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6440951/v1/d03d697816f15d3f0e627b56.png"},{"id":82070424,"identity":"f525ff8d-feb4-44b3-8674-fdb9ea77df6e","added_by":"auto","created_at":"2025-05-06 13:11:19","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":39910,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe transmission routes of AMR pathogens from pigs to humans and the environment\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6440951/v1/35280f63a9e89da2cb48ce00.png"},{"id":82070955,"identity":"485e881b-b77f-4b21-afaa-502a6587415f","added_by":"auto","created_at":"2025-05-06 13:19:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1804448,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6440951/v1/606d1489-51ea-4556-90ab-e2723c166910.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Antimicrobial Resistance in Pig Farming: Prevalence, Transmission Dynamics, Genetic Determinants, and Policy Implication in Tanzania","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAntimicrobial resistance (AMR) is a major global health threat, undermining the effectiveness of antibiotics in treating bacterial infections in humans and animals. The World Health Organization (WHO) has classified AMR as one of the top public health threats, warning that without intervention, drug-resistant infections could become the leading cause of mortality worldwide by 2050 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In both human medicine and livestock farming, excessive and indiscriminate use of antibiotics has contributed to the emergence of multidrug-resistant (MDR) bacteria, complicating disease management, increasing treatment costs, and threatening food safety [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]). The livestock sector, particularly pig farming, is a recognized hotspot for AMR development and transmission due to the frequent use of antibiotics for growth promotion, disease prevention, and treatment [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In Tanzania, pig farming is expanding rapidly, offering economic benefits to smallholder farmers and contributing to national food security. However, this expansion has been accompanied by unregulated antibiotic use, weak veterinary oversight, and a lack of AMR surveillance [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Unlike in some developed countries where strict antibiotic stewardship and surveillance programs exist, Tanzania lacks a comprehensive national AMR monitoring system for livestock. This absence of surveillance increases the risk of resistant bacteria spreading between animals, humans, and the environment through contaminated meat, water sources, and direct contact with farm workers [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Previous AMR studies in Tanzania have primarily focused on poultry and cattle, leaving significant knowledge gaps regarding AMR in pigs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Pigs, however, are highly susceptible to MDR bacteria such as \u003cem\u003eEscherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp.\u003c/em\u003e, and \u003cem\u003eMethicillin-resistant Staphylococcus aureus (MRSA)\u003c/em\u003e, which have the potential for zoonotic transmission [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Despite emerging global concerns over AMR in pig farming, there is limited data on the prevalence, resistance genes, and virulence factors associated with MDR pathogens in Tanzanian pigs. Additionally, there is no systematic assessment of the AMR policy landscape in Tanzania, making it difficult to evaluate whether existing regulations align with global best practices. This study addresses the identified gaps by providing a comprehensive review of MDR pathogens in pigs in Tanzania and assessing their resistance profiles, genetic determinants, and transmission pathways. The findings will help strengthen AMR surveillance and inform policy recommendations by offering evidence-based insights into the following areas: this study identifies the key MDR bacteria present in pigs in Tanzania, highlighting their resistance levels to commonly used antibiotics.\u003c/p\u003e \u003cp\u003eUnderstanding these resistance patterns is crucial for developing targeted interventions to reduce AMR spread; this study compares the prevalence of resistant \u003cem\u003eE. coli\u003c/em\u003e in Tanzanian pigs with findings from other countries, providing a regional and global perspective on AMR trends. This comparison helps determine whether Tanzania\u0026rsquo;s resistance patterns are unique or reflect broader trends seen in Sub-Saharan Africa and beyond; the study examines the resistance and virulence genes associated with MDR pathogens in pigs, such as \u003cem\u003eblaCTX-M, blaTEM, mecA\u003c/em\u003e, and \u003cem\u003etetM\u003c/em\u003e. Identifying these genes provides insights into the molecular mechanisms driving AMR in pig farming and helps predict the risk of horizontal gene transfer, which can accelerate the spread of resistance [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This study highlights how resistant bacteria spread from pigs to humans and the environment through direct contact, foodborne transmission, and environmental contamination. Understanding these pathways is essential for designing biosecurity measures and public health interventions to minimize zoonotic transmission. Assessment of Tanzania\u0026rsquo;s AMR Policies Compared to Other Countries: The study evaluates Tanzania\u0026rsquo;s AMR policy landscape and compares it with policies in South Africa, Kenya, Uganda, the Netherlands, and other nations. Identifying policy gaps and best practices from other countries provides actionable recommendations to strengthen Tanzania\u0026rsquo;s AMR management framework. By aligning the study objectives with these findings, this research provides critical insights into AMR in Tanzanian pig farming, emphasizing the urgent need for improved surveillance, stricter antibiotic regulations, and enhanced public awareness. Additionally, the findings contribute to the broader One Health framework, which recognizes the interconnectedness of human, animal, and environmental health in AMR mitigation strategies.\u003c/p\u003e \u003cp\u003eThis study aims to bridge the knowledge gaps on AMR in Tanzanian pigs by addressing the following specific objectives: (1) to determine the prevalence and antimicrobial resistance profiles of MDR pathogens in pigs in Tanzania (\u003cem\u003eEscherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp., and MRSA\u003c/em\u003e) (2) to compare the prevalence and MDR rates of \u003cem\u003eE. coli\u003c/em\u003e isolated from pigs in Tanzania with other countries in Sub-Saharan Africa and globally (3) to identify resistance and virulence genes associated with MDR pathogens isolated from pigs in Tanzania (4) to examine the major transmission pathways of AMR from pigs to humans and the environment and to evaluate the current AMR policy landscape in Tanzania and compare it with policies in other countries to identify gaps and recommend improvements. The findings of this study are critical for policymakers, veterinarians, farmers, and public health professionals in Tanzania and beyond. By identifying key resistance patterns, genetic determinants, and transmission risks, this research will: support the development of evidence-based AMR surveillance programs tailored to pig farming; guide policymakers in designing effective antibiotic stewardship policies to control AMR in livestock; raise awareness among farmers and veterinarians about responsible antibiotic use and biosecurity measures; provide a comparative framework for understanding Tanzania\u0026rsquo;s AMR burden in relation to other countries; and contribute to regional and global efforts to combat AMR through data-driven interventions and One Health collaborations. In summary, AMR in pig farming is an emerging public health and food safety threat in Tanzania, with implications for human health and environmental sustainability. This study fills critical knowledge gaps by analyzing the prevalence, resistance mechanisms, and transmission dynamics of MDR pathogens in pigs while also assessing the effectiveness of Tanzania\u0026rsquo;s AMR policies. Strengthening AMR surveillance, enforcing stricter antibiotic regulations, and adopting a coordinated One Health approach are essential steps toward mitigating the risks posed by AMR in Tanzania\u0026rsquo;s pig farming sector.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThis review paper aims to provide a comprehensive analysis of the current state of antimicrobial resistance (AMR) in pigs, focusing on multidrug-resistant (MDR) pathogens, their resistance and virulence genes, and their role in the transmission of AMR between pigs, humans, and the environment. The methodology adopted in this study involves systematically reviewing, synthesizing, and comparing research from various sources to address the research problem and gaps in knowledge.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Literature Search and Inclusion Criteria\u003c/h2\u003e \u003cp\u003eA systematic literature search will be conducted using electronic databases such as PubMed, ScienceDirect, Scopus, and Google Scholar. The search will cover articles published from 2000 to 2024 to capture both historical and contemporary perspectives on AMR in pigs. The following keywords and combinations will be used: \"multidrug-resistant pathogens in pigs,\" \"antimicrobial resistance in pig farming,\" \"AMR resistance genes in pigs,\" \"AMR transmission from pigs to humans,\" \"virulence factors in pigs,\" and \"AMR policy in Tanzania.\"\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCriteria for selecting studies relevant to the review and excluding those lacking essential parameters for addressing the research problem\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCriteria\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInclusion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExclusion\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePeer-reviewed articles, government reports, and case studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-peer-reviewed publications (e.g., opinion pieces, editorials)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublication Year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies published from 2000 onwards\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies published before 2000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLanguage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-English studies (unless translated)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeographical Scope\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies focusing on Tanzania, Sub-Saharan Africa, and global context\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies focusing on regions outside Sub-Saharan Africa (unless directly comparable)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathogens\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies on \u003cem\u003eEscherichia coli\u003c/em\u003e, \u003cem\u003eSalmonella spp.\u003c/em\u003e, \u003cem\u003eCampylobacter spp.\u003c/em\u003e, \u003cem\u003eEnterococcus spp.\u003c/em\u003e, \u003cem\u003eMethicillin-resistant Staphylococcus aureus\u003c/em\u003e (MRSA), and other MDR pathogens in pigs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies that do not focus on MDR pathogens or are not related to pig populations\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Focus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResearch on antimicrobial resistance (AMR), resistance and virulence genes, zoonotic transmission, and AMR policy in pigs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies that focus on other aspects of pig health unrelated to AMR or do not investigate AMR in pigs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eData Type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies reporting prevalence rates, resistance patterns, gene detection, and policy analysis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies with insufficient or unclear data on AMR prevalence or resistance patterns in pigs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMethodology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies employing microbiological, molecular, or epidemiological methods for AMR detection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies with unverified methods or lack of transparency in the methodology\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegion Specificity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResearch conducted in Tanzania or comparable Sub-Saharan African countries (in terms of AMR relevance)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies from countries outside the targeted regions (unless they provide context for Tanzania)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntimicrobial Resistance Focus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStudies that assess AMR in livestock with a focus on pigs and its zoonotic impact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStudies on AMR in humans or other animal species not relevant to pigs or livestock\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e2.2 Data Extraction and Synthesis\u003c/h3\u003e\n\u003cp\u003eOnce eligible studies were identified, relevant data were extracted and organized into themes to address the research objectives. Key aspects of each study examined, included: Pathogens Isolated: the types of MDR pathogens commonly isolated from pigs, such as \u003cem\u003eEscherichia coli\u003c/em\u003e, \u003cem\u003eSalmonella spp.\u003c/em\u003e, \u003cem\u003eCampylobacter spp.\u003c/em\u003e, and \u003cem\u003eEnterococcus spp.;\u003c/em\u003e Resistance Profiles: the antibiotics tested, and the resistance profiles of pathogens in relation to commonly used veterinary and human antibiotics (e.g., tetracyclines, beta-lactams, quinolones); Resistance Genes: The identification of resistance genes such as \u003cem\u003eblaCTX-M\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eermB\u003c/em\u003e, \u003cem\u003eaac(3)-IV\u003c/em\u003e, and others in MDR pathogens; Virulence Factors: Identification of virulence genes that contribute to the pathogenicity of the pathogens, such as \u003cem\u003estx1\u003c/em\u003e, \u003cem\u003estx2\u003c/em\u003e, \u003cem\u003eInvA\u003c/em\u003e, and \u003cem\u003ecadF\u003c/em\u003e; Transmission Pathways: Insights into how AMR pathogens are transmitted from pigs to humans and the environment, and the factors that contribute to the spread of resistance; and AMR Policy and Management: An analysis of AMR policies in Tanzania and other Sub-Saharan African countries, including the extent of their implementation and effectiveness. The data were organized in tabular form for clarity, and qualitative synthesis was performed to highlight trends, challenges, and gaps in the current literature.\u003c/p\u003e\n\u003ch3\u003e2.3 Analysis of AMR Policy Implementation\u003c/h3\u003e\n\u003cp\u003eIn addition to reviewing microbiological studies, this review analyzed the policy framework surrounding AMR in pig farming in Tanzania, comparing it with similar policies in Sub-Saharan African countries and high-income nations. The following steps were taken:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePolicy Review\u003c/b\u003e: Relevant government policies, regulations, and guidelines on AMR in Tanzania were reviewed from sources such as the Ministry of Health, the Ministry of Livestock, and international organizations (e.g., WHO, FAO, OIE). A comparison was made between Tanzania\u0026rsquo;s policy landscape and that of other Sub-Saharan African countries with a more developed regulatory framework for AMR.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eEffectiveness Assessment\u003c/b\u003e: The study assessed the reported effectiveness of AMR policies in reducing resistance levels, focusing on whether they address key drivers such as inappropriate antibiotic use in livestock farming, insufficient surveillance, and poor farm biosecurity practices.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eBarriers to Policy Implementation\u003c/b\u003e: The review highlighted challenges to AMR policy enforcement in Tanzania, including insufficient resources, lack of awareness among farmers, and weak regulatory structures. Case studies from other SSA countries were used to draw lessons for improving Tanzania's AMR policy and implementation [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e\n\u003ch3\u003e2.4 Comparative Analysis with Other Countries\u003c/h3\u003e\n\u003cp\u003eThis review included a comparative analysis of AMR in pigs and AMR policy implementation between Tanzania and other countries, both in Sub-Saharan Africa and globally. Countries with active AMR surveillance systems and strong regulatory frameworks, such as South Africa, Kenya, and the Netherlands, were used as benchmarks. Key factors that were compared included: AMR Prevalence: The rate of AMR in pigs in comparison to other livestock species, particularly in countries with advanced surveillance systems; Antimicrobial Usage: The role of antimicrobial use in livestock, particularly in pig farming, and its correlation with AMR prevalence; Policy Responses: The types of policies implemented to curb AMR, including antibiotic stewardship programs, surveillance systems, and regulations on veterinary drug use. This cross-country comparison will allow for a better understanding of how different policy approaches impact AMR trends and offer recommendations for Tanzania.\u003c/p\u003e\n\u003ch3\u003e2.5 Limitations of the Study\u003c/h3\u003e\n\u003cp\u003eGiven the nature of this review, it is important to acknowledge several limitations: Incomplete Data: Some regions may lack published data on AMR in pigs, particularly in low-resource settings like Tanzania; Language Bias: Most studies published in English may overlook local publications in other languages, potentially limiting the comprehensiveness of the review; and Variability in Methodology: Differences in sampling, testing methods, and reporting standards across studies may affect the comparability of results. Despite these limitations, the comprehensive nature of the review will provide valuable insights into the state of AMR in pigs and help inform policy recommendations for Tanzania and other Sub-Saharan African countries.\u003c/p\u003e "},{"header":"Results","content":" \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e3.1 The resistance patterns of MDR pathogens isolated from pigs in Tanzania\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e lists the common MDR bacterial pathogens found in pigs in Tanzania, their sample sources, resistance profiles, and detected resistance genes. \u003cem\u003eEscherichia coli\u003c/em\u003e was the most commonly isolated MDR pathogen, sourced from pig feces and carcasses. It exhibited resistance to tetracycline, ampicillin, and sulfonamides, with \u003cem\u003eblaCTX-M, tetM, aac(3)-IV\u003c/em\u003e, and \u003cem\u003eermB\u003c/em\u003e genes detected. \u003cem\u003eSalmonella spp.\u003c/em\u003e, isolated from pig intestines and feces, showed resistance to ampicillin and ciprofloxacin, carrying \u003cem\u003eblaTEM\u003c/em\u003e and \u003cem\u003etetA\u003c/em\u003e genes. \u003cem\u003eCampylobacter spp.\u003c/em\u003e, found in pig intestines and carcasses, displayed resistance to erythromycin and tetracycline, with the presence of \u003cem\u003eermB\u003c/em\u003e and \u003cem\u003etetO\u003c/em\u003e genes. \u003cem\u003eEnterococcus spp.\u003c/em\u003e exhibited vancomycin and tetracycline resistance, linked to \u003cem\u003evanA\u003c/em\u003e and \u003cem\u003etetM\u003c/em\u003e genes. \u003cem\u003eMethicillin-resistant Staphylococcus aureus (MRSA)\u003c/em\u003e was detected in pig skin, nasal cavities, and feces, resistant to methicillin, oxacillin, and tetracycline, with the \u003cem\u003emecA\u003c/em\u003e and \u003cem\u003etetM\u003c/em\u003e genes contributing to its antimicrobial resistance.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMDR Pathogens in Pigs in Tanzania\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMDR Pathogen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommonly Isolated From\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistance Profile\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResistance Genes Identified\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEscherichia coli\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig feces, carcasses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistant to tetracycline, ampicillin, sulfonamides\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eblaCTX-M\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eaac(3)-IV\u003c/em\u003e, \u003cem\u003eermB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSalmonella spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig intestines, feces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistance to ampicillin, ciprofloxacin, tetracycline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eblaTEM\u003c/em\u003e, \u003cem\u003etetA\u003c/em\u003e, \u003cem\u003estrA\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig intestines, carcasses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistance to erythromycin, tetracycline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eermB\u003c/em\u003e, \u003cem\u003etetO\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEnterococcus spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig feces, intestines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistant to vancomycin, tetracycline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003evanA\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMRSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig skin, nasal cavities, feces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResistant to methicillin, oxacillin, tetracycline, and some beta-lactams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003emecA\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003e3.2 Isolation Frequencies of Resistant Pathogens from Pig Samples in Different Areas of Tanzania\u003c/h3\u003e\n\u003cp\u003eThis table summarizes the isolation frequencies of various MDR pathogens from pig samples in different regions of Tanzania, along with detected resistance genes and virulence factors. The highest \u003cem\u003eE. coli\u003c/em\u003e prevalence was found in Dar es Salaam (73.1%) and Arusha (71.1%), with resistance genes \u003cem\u003eblaCTX-M, mecA, tetM\u003c/em\u003e, and \u003cem\u003eermB\u003c/em\u003e frequently detected. \u003cem\u003eSalmonella spp.\u003c/em\u003e had 66.7% prevalence in carcass samples in Arusha and 5.2% in fecal samples from other regions. \u003cem\u003eCampylobacter jejuni\u003c/em\u003e showed isolation rates between 26.7% (Morogoro) and 34.8% (cecum samples). \u003cem\u003eStaphylococcus aureus\u003c/em\u003e was identified in 4% of nasal swabs in Morogoro, carrying the \u003cem\u003emecC\u003c/em\u003e gene.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIsolation Frequencies of Resistant Pathogens from Pig Samples in Different areas of Tanzania\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudy Area\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSample Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample Size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBacteria Isolated\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIsolation Frequency (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResistance Genes and Virulence Factors Detected\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDar es Salaam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eblaCTX-M\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eaac(6)-Ib-cr\u003c/em\u003e, \u003cem\u003eqnrB\u003c/em\u003e, \u003cem\u003estx1\u003c/em\u003e, \u003cem\u003estx2\u003c/em\u003e (Shiga toxins)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eArusha\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCarcass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eSalmonella spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71.1%\u003c/p\u003e \u003cp\u003e66.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003emecA\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eermB\u003c/em\u003e, \u003cem\u003evanA\u003c/em\u003e,\u003c/p\u003e \u003cp\u003e\u003cem\u003ecadF\u003c/em\u003e, \u003cem\u003eagg\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e864\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter jejuni\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot studied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eMorogoro\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig feces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter jejuni\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot studied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNasal swabs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003emecC\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCecum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter jejuni\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot studied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSmall intestine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter jejuni\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot studied\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCampylobacter coli\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNot studied\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMwanza\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eE. coli\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e93.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eBlaCTX-M-15, strA, strB\u003c/em\u003e,\u003c/p\u003e \u003cp\u003e\u003cem\u003eaac(6)-Ib-cr, qnrS1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003e3.3 Isolation of Resistant\u003c/b\u003e \u003cb\u003eE. coli\u003c/b\u003e \u003cb\u003ein Pigs in Tanzania, SSA, and Global Countries\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis table compares the prevalence and multidrug resistance (MDR) rates of \u003cem\u003eE. coli\u003c/em\u003e in pigs from Tanzania, Sub-Saharan Africa (SSA), and global regions. \u003cem\u003eE. coli\u003c/em\u003e prevalence in Tanzania was 73.1%, with an MDR rate of 51.6%, similar to Uganda (81.4% prevalence, 56% MDR). South Africa had the highest \u003cem\u003eE. coli\u003c/em\u003e prevalence (94%) and MDR rate (67%), while Kenya reported 47.7% prevalence with 38.5% MDR. Industrialized countries like Germany (50.5%) and Spain (26%) had lower prevalence rates, likely due to stricter antibiotic regulations. China had an MDR rate of 96.3%, highlighting high antibiotic use in pig farming.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIsolation of Resistant \u003cem\u003eE. coli\u003c/em\u003e in Pigs in Tanzania, SSA, and Global Countries\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCountry\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSample Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample Size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIsolation Frequency %\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMDR%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSource of Variation of Data\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTanzania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePig feces, carcasses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOveruse of antibiotics, weak surveillance systems, and self-medication among farmers.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKenya\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCarcass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDifferences in farming systems, feed types, and access to veterinary care.\u003c/p\u003e \u003cp\u003eOveruse of antibiotics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUganda\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e56%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInconsistent data due to a lack of proper monitoring and regional differences in farming practices.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRectal swabs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDifferences in Farming practices \u0026amp; overuse of antibiotics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrazil\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal,\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHigh levels of antibiotic use in industrial pig farming contribute to higher resistance rates.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e97.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRegulations on antimicrobial use and farming practices in place lead to a moderate prevalence.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSlaughter wastes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCo-selection through other antimicrobials that are used in pigs (macrolides, lincosamides \u0026amp; tetracyclines)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCarcass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eControlled use of antibiotics in pig farming and regulated veterinary practices.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFecal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLow enforcement of regulations, varied farming systems, and limited surveillance networks.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003e3.4 Comparative Isolation Frequencies of Resistant\u003c/b\u003e \u003cb\u003eE. coli\u003c/b\u003e \u003cb\u003eStrains Globally\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents a comparative analysis of \u003cem\u003eE. coli\u003c/em\u003e isolation rates in pigs from different countries, illustrating variation in resistance levels based on antibiotic use practices and regulations. Tanzania\u0026rsquo;s \u003cem\u003eE. coli\u003c/em\u003e prevalence (73.1%) was higher than Brazil (33.7%) and Spain (26%), but lower than South Africa (94%). Countries with stricter antibiotic regulations (e.g., Spain and Germany) showed lower prevalence, emphasizing the role of regulatory policies in AMR control.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003e3.5 Reported Prevalence Rates of Multidrug-Resistant\u003c/b\u003e \u003cb\u003eE. coli\u003c/b\u003e \u003cb\u003eGlobally\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e illustrates the global prevalence of MDR \u003cem\u003eE. coli\u003c/em\u003e strains in pig farming, comparing Tanzania\u0026rsquo;s rates with those from other regions. MDR rates were highest in India (100%) and China (96.3%), while Tanzania had a moderate MDR rate (51.6%). European countries, such as Spain (97.5%) and Germany (49.2%), showed controlled resistance levels due to regulated antibiotic usage.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Resistance and Virulence Genes in MDR Pathogens\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e summarizes the resistance and virulence genes identified in MDR pathogens isolated from pigs in Tanzania. \u003cem\u003eE. coli\u003c/em\u003e carried resistance genes \u003cem\u003eblaCTX-M, tetM, ermB\u003c/em\u003e, along with virulence genes \u003cem\u003estx1, stx2\u003c/em\u003e (Shiga toxins). \u003cem\u003eSalmonella spp.\u003c/em\u003e harbored \u003cem\u003eblaTEM\u003c/em\u003e and \u003cem\u003etetA\u003c/em\u003e, with virulence genes \u003cem\u003einvA\u003c/em\u003e and \u003cem\u003efimH\u003c/em\u003e, known for enhancing bacterial adhesion. \u003cem\u003eMRSA\u003c/em\u003e contained the \u003cem\u003emecA\u003c/em\u003e gene for methicillin resistance and virulence factors \u003cem\u003eclfA, cna\u003c/em\u003e, and \u003cem\u003espa\u003c/em\u003e, increasing its pathogenic potential.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResistance and Virulence Genes in MDR Pathogens\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathogen\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResistance Genes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVirulence Genes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEscherichia coli\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eblaCTX-M\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eaac(3)-IV\u003c/em\u003e, \u003cem\u003eermB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003estx1\u003c/em\u003e, \u003cem\u003estx2\u003c/em\u003e (Shiga toxins), \u003cem\u003eInvA\u003c/em\u003e, \u003cem\u003ecadF\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSalmonella spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eblaTEM\u003c/em\u003e, \u003cem\u003etetA\u003c/em\u003e, \u003cem\u003estrA\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003einvA\u003c/em\u003e, \u003cem\u003espvC\u003c/em\u003e, \u003cem\u003efimH\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eCampylobacter spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eermB\u003c/em\u003e, \u003cem\u003etetO\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ecadF\u003c/em\u003e, \u003cem\u003echeW\u003c/em\u003e, \u003cem\u003eCj1349\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEnterococcus spp.\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003evanA\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eesp\u003c/em\u003e, \u003cem\u003eagg\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMethicillin-resistant \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (MRSA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003emecA\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eclfA\u003c/em\u003e, \u003cem\u003ecna\u003c/em\u003e, \u003cem\u003espa\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.7 Role of Pigs in Transmission of AMR to Humans and Environment\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e5\u003c/span\u003e highlights the major transmission routes of AMR pathogens from pigs to humans and the environment, along with estimated risk levels. Direct contact with pigs poses the highest AMR transmission risk (40%) for farm workers. Consumption of undercooked pork is responsible for 30% of AMR spread. Environmental contamination through manure and wastewater accounts for 25% of AMR transmission.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRole of Pigs in Transmission of AMR to Humans and Environment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTransmission Route\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKey Findings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEstimated Risk/Impact of AMR Spread\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDirect Contact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmers and farm workers are at higher risk of carrying MDR pathogens due to direct contact with pigs.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40% risk of AMR transmission to humans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsumption of Undercooked Pork\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndercooked pork is a source of AMR pathogens, especially \u003cem\u003eE. coli\u003c/em\u003e and \u003cem\u003eSalmonella\u003c/em\u003e.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30% risk of AMR spread through food\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnvironmental Contamination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAMR pathogens are transmitted to the environment through pig manure and wastewater, contributing to soil and water contamination.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25% impact on soil and water systems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarm Workers as Carriers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAMR pathogens are carried by farm workers to homes, local communities, and markets.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20% impact on community AMR spread\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.8 The Transmission Routes of AMR Pathogens from Pigs to Humans and the Environment\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates the pathways through which AMR pathogens spread from pigs to humans and the environment. Direct pig-human contact is the primary route of transmission. Foodborne transmission occurs through contaminated pork products. Environmental pathways include AMR dissemination through soil and water contamination.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.9A AMR Policies in Tanzania and Comparison with Other Countries\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e6\u003c/span\u003e compares the AMR policy status in Tanzania with several other countries, including South Africa, Kenya, Uganda, the Netherlands, and the USA. Tanzania is shown to have a limited formal AMR policy framework, with inadequate enforcement of antibiotic use regulations in agriculture. In contrast, countries like South Africa and the Netherlands have established comprehensive AMR policies with strong regulatory frameworks and surveillance systems. The table highlights the gaps in Tanzania's AMR strategy, particularly in areas such as antibiotic use regulation and surveillance, which are more robust in the comparison countries. The findings suggest that Tanzania could benefit from a more coordinated and well-enforced AMR policy to reduce the spread of resistant pathogens in livestock.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAMR Policies in Tanzania and Comparison with Other Countries\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCountry/Region\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAMR Policy Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKey Findings\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTanzania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLimited formal AMR policy framework. \u003c/p\u003e \u003cp\u003eInsufficient regulatory enforcement on antibiotic use in agriculture.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLack of comprehensive AMR surveillance programs. \u003c/p\u003e \u003cp\u003eNeed for stronger regulation of veterinary antibiotics.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth Africa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEstablished AMR policy framework with national surveillance systems.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStronger regulatory enforcement. \u003c/p\u003e \u003cp\u003eEffective AMR surveillance in livestock.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKenya\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAMR policy was implemented with a focus on human health but limited enforcement in agriculture.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGrowing recognition of the role of animal agriculture in AMR transmission.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUganda\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLimited but developing AMR strategy with nascent surveillance programs.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIncreased focus on zoonotic transmission, but gaps in AMR data collection and analysis.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNetherlands\u003c/p\u003e \u003cp\u003e(Global)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive AMR policies and regulations, including restrictions on antibiotic use in livestock.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAdvanced surveillance systems and enforcement of antibiotic stewardship programs in livestock farming.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.9B Recommendations for Improving AMR Policy in Tanzania\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e7\u003c/span\u003e outlines key recommendations to improve AMR policy in Tanzania, based on the findings from the review. The recommendations include strengthening the regulatory framework for antibiotic use in livestock, developing national AMR surveillance systems, implementing awareness programs for farmers and farm workers, and fostering international collaborations to improve resource availability and technical support. The expected outcomes of these interventions include reduced antibiotic misuse in farming, improved AMR data collection, and more effective control measures to curb the spread of resistance. The recommendations also highlight the importance of integrating AMR control into broader public health and agricultural strategies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecommendations for Improving AMR Policy in Tanzania\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecommendation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKey Actions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExpected Outcomes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReferences\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrengthening Regulatory Framework\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTightening regulations on antimicrobial use in livestock. \u003c/p\u003e \u003cp\u003e Introduction of stricter licensing for veterinary drugs.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReduced use of unnecessary antibiotics in pig farming.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeveloping National AMR Surveillance Systems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEstablishment of a nationwide AMR surveillance network, including farms, slaughterhouses, and markets.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eImproved data on AMR prevalence and spread. \u003c/p\u003e \u003cp\u003eBetter informed policies.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarmer and Worker Awareness Programs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEducational programs focusing on responsible antibiotic use, biosecurity, and hygiene practices.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReduction in AMR transmission within farms and communities.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrengthening International Collaborations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollaboration with international organizations (e.g., WHO, FAO) to implement best practices in AMR control.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIncreased resource availability and technical support.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study revealed high prevalence rates of MDR \u003cem\u003eE. coli\u003c/em\u003e (73.1%) and other MDR pathogens such as \u003cem\u003eSalmonella spp.\u003c/em\u003e, \u003cem\u003eCampylobacter spp.\u003c/em\u003e, \u003cem\u003eEnterococcus spp.\u003c/em\u003e, and MRSA in Tanzanian pigs (Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The detection of genes such as \u003cem\u003eblaCTX-M\u003c/em\u003e, \u003cem\u003etetM\u003c/em\u003e, \u003cem\u003eermB\u003c/em\u003e, \u003cem\u003emecA\u003c/em\u003e, and \u003cem\u003evanA\u003c/em\u003e indicates the presence of extensive resistance mechanisms in these bacteria. These findings align with studies from other Sub-Saharan African (SSA) countries, including Uganda and Kenya, where similar resistance genes were detected in livestock [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. However, compared to European countries such as Germany and the Netherlands, where strict antibiotic stewardship is enforced, Tanzania's resistance prevalence is significantly higher [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. This suggests that weak surveillance and unregulated antibiotic use in Tanzanian pig farming contribute to escalating AMR. The implications of these findings are severe, as MDR bacteria can be transmitted from pigs to humans through direct contact or foodborne pathways, increasing the risk of untreatable infections. The resistance patterns observed in Tanzanian pigs underscore the urgent need for strengthened AMR surveillance and stricter regulations on antibiotic use in livestock farming. The comparison of \u003cem\u003eE. coli\u003c/em\u003e resistance levels globally (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e, Figs.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), shows that Tanzania's prevalence (73.1%) is among the highest, comparable to South Africa (94%) but lower than Uganda (81.4%). Meanwhile, industrialized countries like Germany (50.5%) and Spain (26%) have significantly lower rates due to stringent antibiotic use regulations [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Interestingly, China and India report alarmingly high MDR rates of \u003cem\u003eE. coli\u003c/em\u003e (\u0026gt;\u0026thinsp;96%), which can be attributed to excessive antibiotic use in intensive pig farming [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. The similarity between Tanzania and other SSA nations suggests common drivers of AMR, including unregulated antibiotic access, lack of veterinary oversight, and poor farm hygiene [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. The high MDR \u003cem\u003eE. coli\u003c/em\u003e prevalence in Tanzania means that resistant bacterial strains could enter the human food chain, increasing the burden of AMR-related diseases. Learning from countries like the Netherlands, which have significantly reduced AMR through national stewardship programs [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], Tanzania must develop policies to regulate antibiotic use in livestock farming.\u003c/p\u003e \u003cp\u003eThe study identified key resistance genes (\u003cem\u003eblaCTX-M, blaTEM, mecA, tetM, vanA\u003c/em\u003e) and virulence genes (\u003cem\u003estx1, stx2, invA, fimH\u003c/em\u003e) in MDR pathogens (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The presence of \u003cem\u003estx1\u003c/em\u003e and \u003cem\u003estx2\u003c/em\u003e in \u003cem\u003eE. coli\u003c/em\u003e suggests a high risk of severe diarrheal diseases in humans, while \u003cem\u003emecA\u003c/em\u003e-positive MRSA strains indicate a zoonotic threat [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Compared to global data, Tanzanian pigs harbor resistance genes similar to those found in China, Brazil, and India, reinforcing concerns over the horizontal gene transfer of resistance elements [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. The risk of zoonotic transmission and environmental contamination increases when these resistant pathogens persist in livestock populations. Immediate intervention strategies, including better veterinary oversight and biosecurity measures, are necessary to mitigate these risks in Tanzania. Direct pig-human contact was identified as the highest-risk transmission route (40%), followed by consumption of undercooked pork (30%) and environmental contamination (25%) (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e5\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). These findings align with studies from South Africa, where farm workers frequently act as carriers of resistant bacteria [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Furthermore, poor waste management in Tanzanian pig farms exacerbates environmental contamination, allowing AMR pathogens to persist in water and soil [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. Given these transmission pathways, biosecurity measures such as improved hygiene practices, controlled antibiotic use, and proper manure disposal are critical in Tanzania. Lessons from the European Union [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], where strict sanitation protocols and controlled antibiotic use have reduced AMR transmission, could guide interventions in Tanzania.\u003c/p\u003e \u003cp\u003eTanzania's AMR policy framework is weak compared to South Africa and the Netherlands, which have well-established national AMR surveillance programs and strict antibiotic regulations [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Kenya and Uganda have made strides in AMR control but still lack stringent enforcement mechanisms [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The absence of a national AMR monitoring system in Tanzania allows for unchecked antibiotic use, exacerbating resistance rates. Implementing a structured AMR policy, similar to the Netherlands\u0026rsquo; national antibiotic reduction program, could significantly curb resistance development in livestock [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]. Tanzania must strengthen its regulatory framework and enforce stricter antibiotic stewardship measures to align with global best practices. The key recommendations (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e6\u003c/span\u003e) include: implementing stricter laws on veterinary antibiotic use and improving drug licensing regulations [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]; monitoring AMR trends across farms, slaughterhouses, and markets to track resistance patterns [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]; educating stakeholders on responsible antibiotic use, biosecurity, and hygiene measures [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]; investing in research and international collaborations such as partnering with WHO, FAO, and regional organizations to develop AMR control strategies [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The study highlights a critical AMR burden in Tanzanian pig farming, emphasizing the need for urgent policy interventions. High MDR pathogen prevalence, resistance gene detection, and weak regulatory enforcement pose severe threats to public health. Drawing lessons from global best practices, Tanzania must strengthen antibiotic regulations, enhance surveillance, and promote responsible antimicrobial use to mitigate the AMR crisis in livestock farming.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights a critical AMR burden in Tanzanian pig farming, emphasizing the need for urgent policy interventions. High MDR pathogen prevalence, resistance gene detection, and weak regulatory enforcement pose severe threats to public health. Drawing lessons from global best practices, Tanzania must strengthen antibiotic regulations, enhance surveillance, and promote responsible antimicrobial use to mitigate the AMR crisis in livestock farming.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003e​To effectively combat antimicrobial resistance (AMR) in Tanzania's livestock sector, the following key policy recommendations are proposed:​\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e1. Strengthen Regulatory Frameworks\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eEnforce Prudent Use: Regulate antimicrobial use, limiting it to therapeutic purposes under veterinary oversight.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eRestrict OTC Sales: Ban the sale of critical antimicrobials without prescription to curb misuse.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e2. Enhance Surveillance and Monitoring\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eBuild Surveillance Systems: Develop integrated systems to track antimicrobial use and resistance across sectors.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePromote Research \u0026amp; Data Sharing: Support research and dissemination to guide policy and action.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e3. Promote Education and Awareness\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eTrain Stakeholders: Provide ongoing training for farmers, vets, and health workers on responsible use and AMR risks.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eRaise Public Awareness: Run national campaigns highlighting AMR and proper treatment adherence.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e4. Improve Biosecurity and Farming Practices\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePromote Good Husbandry: Encourage disease-preventive practices to reduce antimicrobial needs.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStrengthen Biosecurity: Enforce strict farm biosecurity to block infection spread.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003e5. Invest in Vaccination Programs\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eDevelop and Distribute Vaccines: Boost vaccine use to prevent infections and reduce antimicrobial reliance.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e6. Foster One Health Collaboration\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePromote Cross-Sector Coordination: Unite human, animal, and environmental sectors against AMR.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePartner Internationally: Work with global bodies and neighbors to share AMR solutions and resources.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eImplementing these recommendations requires a coordinated effort from government agencies, the private sector, and civil society to effectively mitigate the threat of AMR in Tanzania's livestock industry.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This work was not funded. There was no any funding received for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: All authors; Writing the original draft: V.S.S.; Writing-review \u0026amp; Editing: B.L.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval:\u0026nbsp;\u003c/strong\u003eThis study is a literature-based review, so ethical clearance was not required. However, ethical integrity was ensured by properly citing all sources, avoiding plagiarism, and acknowledging the original authors of all data used.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate declaration\u003c/strong\u003e: not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003eLivestock Training Agency (LITA), Buhuri Campus, P.O. Box 1483, Tanga, Tanzania. [email protected] \u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003eNelson Mandela African Institution of Science and Technology (NIM-AIST), P. O. Box 447, Arusha, Tanzania. 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W., \u003cem\u003eThe significance of antimicrobial resistance in environmental reservoirs: Review and analysis of global patterns.\u003c/em\u003e. Science of the Total Environment,, 2015. 536: p. 29\u0026ndash;42..\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePanel, E.B., et al., \u003cem\u003eOccurrence and spread of carbapenemase-producing Enterobacterales (CPE) in the food chain in the EU/EFTA. Part 1: 2025 update\u003c/em\u003e. EFSA Journal, 2025. 23(4): p. e9336.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Antimicrobial Resistance, Multidrug-Resistant Pathogens, Pig Farming, Resistance Genes, Zoonotic Transmission, One Health, AMR Surveillance, Tanzania, Antibiotic Stewardship","lastPublishedDoi":"10.21203/rs.3.rs-6440951/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6440951/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAntimicrobial resistance (AMR) poses a critical global health threat, impacting human, animal, and environmental health. Pigs act as significant reservoirs for multidrug-resistant (MDR) pathogens; however, there is limited data regarding their role in AMR transmission in Tanzania. This study synthesizes existing data on the prevalence, resistance profiles, and genetic determinants of MDR pathogens in pigs, assesses transmission pathways and evaluates Tanzania\u0026rsquo;s AMR policies in comparison to regional and global strategies. A systematic review of peer-reviewed literature, government reports, and case studies focuses on MDR bacteria, including Escherichia coli, Salmonella spp., Campylobacter spp., Enterococcus spp., and methicillin-resistant Staphylococcus aureus (MRSA). E. coli demonstrated a prevalence of up to 73.1% and 51.6% multidrug resistance, while Salmonella spp. and Campylobacter spp. exhibited notable resistance to tetracyclines, beta-lactams, and quinolones. Key resistance genes, such as blaCTX-M, tetM, ermB, mecA, and vanA, were identified, highlighting the potential for horizontal gene transfer and zoonotic transmission. Major AMR transmission routes include direct contact, foodborne exposure, and environmental contamination. Tanzania\u0026rsquo;s AMR surveillance in pig farming is limited, with weak enforcement of antibiotic regulations and the absence of a coordinated national monitoring system. Comparative policy analysis reveals significant gaps, calling for stricter antibiotic control, improved AMR monitoring, and public education. A One Health approach is crucial, integrating veterinary, public health, and environmental interventions. Strengthening regional collaboration and aligning Tanzania\u0026rsquo;s AMR policies with global standards is essential to effectively combat the growing AMR threat.\u003c/p\u003e","manuscriptTitle":"Antimicrobial Resistance in Pig Farming: Prevalence, Transmission Dynamics, Genetic Determinants, and Policy Implication in Tanzania","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-06 13:11:14","doi":"10.21203/rs.3.rs-6440951/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f8d23600-d820-420e-9a07-fe0a7dc73f3c","owner":[],"postedDate":"May 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-06T13:11:14+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-06 13:11:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6440951","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6440951","identity":"rs-6440951","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}